Annals of Hematology

, Volume 92, Issue 8, pp 1023–1032 | Cite as

Persisting fatigue in Hodgkin lymphoma survivors: a systematic review

  • Laurien A. Daniëls
  • Simone Oerlemans
  • Augustinus D. G. Krol
  • Lonneke V. van de Poll-Franse
  • Carien L. Creutzberg
Review Article


Hodgkin Lymphoma (HL) survivors are at risk for adverse psychosocial events as a result from cancer diagnosis and treatment. Fatigue is one of the most frequently reported long-term symptoms and is often reported to interfere with daily life. We conducted a systematic review to determine prevalence, severity and predisposing factors of fatigue in HL survivors. A literature search was conducted up to August 2012. Twenty-two articles comparing HL survivors with norm population data met all predefined selection criteria. Prevalence rates, levels of fatigue and clinical relevance of the results were determined. Prevalence of fatigue ranged from 11–76 % in HL survivors compared to 10 % in the general population. Mean fatigue scores were 5–13 % higher compared to the normative population; these findings were clinically relevant in 7 out of 11 studies. Increasing age was associated with higher levels of fatigue in HL survivors. Treatment modality and stage of initial disease were not associated with higher fatigue levels, while comorbidities or other treatment sequelae seemed to impact on the levels of fatigue. HL survivors are at serious risk for developing clinically relevant, long-term fatigue. The impact of patient and treatment characteristics on risk of fatigue is limited. Focus for future research should shift to the role of late-treatment sequelae and psychological distress symptoms.


Hodgkin lymphoma Fatigue Vitality Health-related quality of life 



The authors have declared no conflicts of interest.

Supplementary material

277_2013_1793_MOESM1_ESM.doc (241 kb)
ESM 1 (DOC 241 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Laurien A. Daniëls
    • 1
  • Simone Oerlemans
    • 2
    • 3
  • Augustinus D. G. Krol
    • 1
  • Lonneke V. van de Poll-Franse
    • 2
    • 3
  • Carien L. Creutzberg
    • 1
  1. 1.Departments of Clinical Oncology, K1-PLeiden University Medical CenterLeidenThe Netherlands
  2. 2.Comprehensive Cancer Centre SouthEindhovenThe Netherlands
  3. 3.Center of Research on Psychology in Somatic Diseases (CoRPS)Tilburg UniversityTilburgThe Netherlands

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